Deprivation and the Development of Obesity a Multilevel, Longitudinal Study in England

Background: Evidence indicates that the rising trend in overweight and obesity may be stronger for people from more socioeconomically advantaged backgrounds.

Purpose: This study used longitudinal, multilevel data to describe trajectories of BMI for people living in more- versus less-deprived neighborhoods.

Methods: Data from 2501 women and 5650 men in the Whitehall II study who were followed for up to 13 years from 1991 to 2004 were analyzed in 2009. BMI was measured on up to three occasions by a trained nurse. The Townsend index of multiple deprivation at census-ward level from the 1991 U.K. census captured neighborhood deprivation. Growth curves summarized change in BMI for men and women according to level of neighborhood deprivation, adjusted for age, individual socioeconomic position (captured by civil service employment grade), smoking status, alcohol intake, and physical activity level.

Results: Women who remained in the most-deprived neighborhoods between 1991 and 2004 had higher initial BMI and greater weight gain. Compared to those in the least-deprived neighborhoods, weight gain for a woman of average height in one of the most-deprived neighborhoods was 1.0 kg more over 10 years. Neither BMI nor change in BMI in men was associated with neighborhood deprivation.

Conclusions: Whitehall II provides longitudinal evidence of socioeconomic differences in weight gain among middle-aged women, indicating that the neighborhood environment makes a contribution to the development of overweight and obesity.